November 2025 Newsletter

Methylene blue has become a popular oral supplement touting legitimate benefits for mitochondrial health, neurocognitive function and protection, antioxidant and anti-inflammatory effects, and mood enhancement. As with most supplements, using the appropriate dose is very important in order to enjoy the potential benefits and avoid the possible detrimental side effects. In general, while a dose of up to 3-4mg per kilogram of bodyweight can benefit mitochondrial, cognitive and psychological/mood function, a dose above 1-2mg per kilogram per day can decrease nitric oxide production, and, for most of us, that is something to avoid because of the potential benefits of maintaining nitric oxide production including significant all-cause mortality reduction. Bottom line: if interested in using methylene blue, take no more than 2mg per kilogram per day, and, DO NOT take methylene blue if taking certain antidepressant drugs or serotonergic agents (SSRI’s, SNRI’s, MAO-inhibitors and Tramadol).

Estrogen in replacement therapy for women is crucial for many women and the recent removal of “Black Box Warnings” for women is long overdue and reflects recognition of a flaw in one of the most comprehensive and cited studies for woman conducted known as “The Women’s Health Initiative” (WHI). In short, the mistake made was in the use of “Premarin” as the form of estrogen replacement. “Premarin”, which stands for PREgnant MARe urINe, contains approximately 50% equilin which is a horse estrogen whose effect on humans is very potent. The upshot is that the WHI study showed that its use led to an increased risk – albeit slight yet still significant – of developing estrogen sensitive cancers and strokes. To date, there has been no link made to the use of bioidentical (human) estrogens (estradiol and/or estriol) as replacement therapy, nor has a link been made – despite some assertions to the contrary – to the timing of initiation of estrogen therapy (within a range of years before and after menopause). Bottom line: therapeutic use of bioidentical estrogen in women– systemically or locally – can improve health (brain, heart, vaginal, urological and bone/joint) and quality of life with no established increased risk of cancer or stroke.

Full-body MRI’s and other imaging such as a coronary CT angiogram with and without contrast and NeuroQuant MRI are becoming popular tools for screening of issues that can be identified “early”, and therefore addressed and treated with a greater likelihood of success. RSM has an agreement for discounted pricing with Prenovo, a Nationwide provider of full-body MRI’s as well as Medical Imaging Center of Southern California (MICSC) for full-body MRI’s, Coronary CT angiograms, and the “NeuroQuant” imaging. Of particular interest for those concerned with their predilection for development of dementia and other neurological deficits in the brain is the NeuroQuant MRI which can determine “hippocampal occupancy” and risk for development of diseases of the brain. Useful for anyone concerned about their long-term risk of dementia, it is of particular potential benefit for those who carry the APOE-4 alleles associated with early onset dementia.

Genome mapping once made little sense because there was little we could do to “treat” or control what our choice of parents did for us, and, the cost of mapping was over $10,000 IF you could find a lab that could find enough other interested parties to do it with you to make it practical and feasible. Today, one can map one’s genome for less than $1,000, and can learn – with continuous updates as we daily discover more – about, eg, ways in which our genes affect our predilection for cancers and heart disease as well as other practical applications such as our ability to thrive on more or less sleep or to metabolize caffeine or benefit from certain drugs or not. Bottom line: if you really want to optimize your healthspan and efficiently manage your health and treatment options, having your genome mapped is an essential tool.

CellGym is an apparatus that enables the use of Intermittent Hypoxic and Hyperoxic Therapy (IHHT) for a myriad of purposes to enhance health and fitness. While relaxing comfortably in a chair, one can breathe air manipulated to contain as little as 1/3 the partial pressure of oxygen at sea level or about the same effect as breathing at 5,000 meters (16,404 feet) of altitude followed by a mix of air containing and as much as 35% oxygen. The effect of this is to improve mitochondrial and endothelial function and upregulate nitric oxide and antioxidant production. The net result to health is improved cognition, metabolic function and athletic performance and reduced systemic inflammation all of which are tied to reduced all-cause mortality through their direct connection to Coronary Artery Disease, Cancer, Neurological Disorders (Alzheimer’s Disease and Dementia), and Type 2 Diabetes.

5-alpha reductase inhibitors (finasteride (Propecia and Proscar), dutasteride (Avodart), and saw palmetto) with nandrolone have long been discouraged citing the desire to allow nandrolone to convert to dihydronandrolone – a metabolite of nandrolone with much weaker androgenic effects (typically desired) than nandrolone itself. However, we now know that these aforementioned chemicals and the 5-alpha reductase inhibition have no effect on nandrolone and therefore can be employed concurrently for their intended effect to prevent testosterone from metabolizing into dihydrotestosterone – a strongly androgenic hormone that at various sufficient levels is responsible for initiating head hair loss, body and facial hair growth, acne, vocal cord thickening (voice deepening) and clitoral enlargement. Bottom line: you can take 5-alpha reductase inhibitors (finasteride (Propecia and Proscar), dutasteride (Avodart), and saw palmetto) to avoid potential negative side effects of dihydrotestosterone while also taking nandrolone.

Lastly, many of you did not receive the April newsletter that contained, among other items, information regarding blood thickness and stroke (“Thrombosis (blood clots), Blood Viscosity (“thickness”), and Testosterone”), and, for the men, testosterone and prostate cancer (“Testosterone & Prostate Cancer”). Please take a moment to read these as they dispel the very common misinformation circulating even amongst physicians.